Nonuremic Idiopathic Calciphylaxis in a Patient With Preceding Warfarin Use and Iron Infusions

Abstract

Calciphylaxis is a rare and life-threatening illness characterized by microvessel occlusion due to calcification, fibro-intimal hyperplasia, and thrombosis in the subcutaneous adipose tissue and dermis. Calciphylaxis is most commonly associated with end-stage renal disease (ESRD) and other risk factors, including obesity, diabetes mellitus, primary hyperparathyroidism, warfarin use, and with a potential link to iron infusions and loop diuretics. We report on a patient with nonuremic, idiopathic calciphylaxis with exposure to warfarin, iron infusion therapy, and loop diuretics, treated with sodium thiosulfate. We further discuss the potential risk factors for calciphylaxis development in nonuremic patients.